MR imaging of brachial plexopathy in breast cancer patients without palpable recurrence

Abstract

MR imaging demonstrated masses involving the BP representing metastases in two patients. Nine patients had other regional abnormalities with a normal brachial plexus. It is concluded that MR imaging is useful in the assessment and direction of therapy of brachial plexopathy in breast cancer patients by detecting both metastases to the BP as well as other abnormalities, unrelated to the BP, which may explain the patient's symptoms.

Une cause rare de plexopathie brachiale : une metastase d’un cancer du sein

“…L'examen clinique révèle un déficit moteur, une atrophie musculaire et une hypoesthésie dans 75% des cas. Le syndrome de Claude Bernard Horner survient dans 50% des cas [ 1 ].…”

Effective treatment of the brachial plexus syndrome in breast cancer patients by early detection and control of loco-regional metastases with radiation or systemic therapy

“…These were apparent on the physical examination in 22 patients, but, like others, we found imaging necessary to detect brachial plexus involvement in M0, no distant metastases other than axillary nodes c N0, no involved axillary nodes; N1, at least one axillary node; N2, matted axillary nodes d M1, metastases to distant sites, such as bone or lung, detectable by imaging e The supraclavicular and axillary regions were included in the radiation portal in 10 of the 13 patients who received primary radiation f Adjuvant or neoadjuvant chemotherapy, or initial chemotherapy for those patients who presented with metastatic disease g Long-term tamoxifen or anastrazole therapy; all these patients previously had chemotherapy h Months elapsing between original breast cancer presentation and fi rst evidence of brachial plexus syndrome a Narcotic analgesics not necessary to control pain b Narcotic analgesics necessary to control pain c Paresis relative to contralateral arm d Severe disability or complete paralysis e C5-6 Division involvement f C7-T1 Division involvement some patients. [11][12][13][14][15][16] In one patient computer-automated tomography, and in 4 magnetic resonance imaging (MRI) was necessary to demonstrate loco-regional metastases, including tumor within the brachial plexus. Two patients without loco-regional metastases developed pain and arm weakness 14 and 32 months after surgery and radiation.…”

Medical imaging in the diagnosis and management of cancer pain

“…4). In the postradiation therapy population with chronic pain, MRI can often help distinguish radiation induced from tumor-related pain [26][27][28]. A promising technique to improve the specifi city of brachial plexus MR neurography is diffusion-weighted images, in which injured nerves may show pronounced restriction in diffusion and appear bright compared with normal intact nerves [29•].…”